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Could you please explain to us what Duanes Retraction Syndrome is? It is to do with bpes?

Thanks

Re: blepharophimosis Re: BPES : 14 month old from Germany

Yes, i have 2 sons with bleph and myself. I only had 2 surgeries. My grandfather and my father also had bleph. My father never had any surgery for his, but he passed away when i was 5. My grandfather is almost 80 and he finally gave in and decided to have only 1 eye fixed. That was about 7 months ago. He has no interest in getting the other eye fixed at all. My oldest son Austin only had to have 2 surgeries for bleph, but he also had to have tubes in his tear ducts because they were blocked. Austin had just turned 5 yrs old when he had his first surgery and he was 6 almost 7 when he had the 2nd. His surgeon said that there had to a certain amount of distance between the knee and the hip before they could have the muscle from his leg. When i had mine i had donor muscle brought in. This is going to be Garrett's first "permanent" surgery. He had a "temporary" surgery don't when he was 4 months old to raise the eyelids just enough over the pupil so that he wouldn't go blind. I was told that it could come undone. About 2 years ago he had surgery for Duanes Retraction Syndrome and after that surgery i did notice that one of his eyelids was alot lower than it had been. The docs didn't seem to concerened about it though. After this surgery for Garrett on Friday the surgeon said that we had to wait 4-6 months before we could do the next one. Their surgeon told me when Austin had his 2nd surgery that usually bleph gets better as it's passed down, but in our case it has gotten worse. The surgeon said that when he cut open the eyelids there was alot of scar tissue in there, and he hadn't had surgery on his eyelids before. I thought that was kind of interesting. Garrett's eyes are alot worse than mine or Austins. Garrett does have cup shaped ears, but i don't. Austin's are small, but i don't really think they are cup shaped. I have plenty of pictures of all 3 of us if i could ever get a darn scanner. Mine broke right before i joined this group i guess. I went to scan some pictures and it didn't work. Guess it just gave one day without me knowing it. I'm hoping to get one soon though. If you want to know anything else feel free to ask.

I'll let everyone know how things turn out of Friday.

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Thanks for that. As far as we know, it doesn't appear to be the case with our daughter who is only 8 1/2 months old.

It is great to read all the messages! We are learning so much and some of your stories are so inspiring to us.

Re: blepharophimosis Re: BPES : 14 month old from Germany

Nothing was ever mentioned to me that Duanes Retraction Syndrome was associated with bpes, but what it is...either the muscle that controls the eye is too loose or too tight. To us it would look like Garrett was looking to the left or right, but he would actually be looking straight ahead. His muscles were too tight, and I can't really remember what exactly they did. I do remember the doc. saying that they would snip the muscle but that's about all i remember. Sorry.

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  • 5 years later...

Anja... My son never cried tears until he was

three. The surgeon went in and tightened the tendons

in his bottom lids at the same time of suspending his

brows. He said that the lack of tightness in his

bottom lids was the major cause of his light

sensitivity because his corneas were drying out ( they

weren't providing the wiping action that a normal lid

would) Also he couldn't cry tears because the lids

were so loose that they just pooled in the bottom lids

and drained back down. As soon as they tightened

them..he cried tears. It was kind of a strange joy

for us! I'm not sure exactly what the procedure is

called...but he had an incision about an inch long

from the outer corner of each of his eyes. It looked

pretty rough for about 2 weeks...but now if you didn't

know he had it done, you don't even see the scars! I

don't have any pictures of him post-operative tho.

Not sure if this info is what you were looking for but

hope it's useful!

Take Care

a

--- Anja Shahin <anjashahin@...> wrote:

> Hi ,

>

> thanks for sharing your experience and the adresses.

> You are talking

> about a the tear problem, actually one of my major

> concerns ..... as

> a does not seem to have tears at all (not even

> when she is

> crying). However it does not seem to be a problem

> right now, but I am

> afraid that it will get worse after surgery. We have

> been told by a

> plastic surgeon that she will not be able to close

> her eyes after

> surgery any more and that this could cause major

> problems, even lead

> to blindness!!!!!!! Im totally confused now of

> course. Hope to

> hearing from one of you who has had the surgery done

> already.

>

> Anja

>

>

>

> > Hello,

> >

> > My name is . I'm french. I'm 30 years old. I

> have BPES.

> > I want to answer to and Anja.

> >

> > Anja, I am a sporadic case of BPES. It means that

> nobody in my

> family has BPES, except me. No matter. I am not

> asking myself all day

> long if one of my parents had geneticly somethin

> wrong. They have no

> responsability in my BPES. What'smore, BPES is not

> an handicap if the

> parents find a surgeon. Thanks to surgeries, we can

> see and live

> normally. Of course, we have problems to bear the

> light of the sun

> and sometimes electric light, we have not many tears

> and they are of

> bad quality. We look a bit different. I

> > don't shame my difference, I'am proud of it.

> >

> > And if I can have a baby (I don't know if I can or

> not because of

> BPES), my baby will maybe have BPES (50% it has

> BPES, 50% it has

> not).If it has BPES, I know how to help it, because

> I lived the same

> things it lives.

> >

> > Anja, your daughter should get a genetic testing

> too, because you

> (and she) would maybe know if she will have problems

> of premature

> ovarian failure (POF), that concern sometimes women

> who have BPES.

> >

> > In Paris, several hopital make surgeries. I had

> three surgeries in

> Hôpital Saint Antoine, but my surgeon doesn't work

> anylonger (Pr

> SARAUX).

> >

> > In Hôpital NECKER-ENFANTS MALADES, you can contact

> Pr Jean-Louis

> DUFIER (00.33.1.44.49.45.02). The address is 149

> -161 rue de Sèvres

> 75015 PARIS, Métro DUROC.

> >

> > I have no name of surgeon in these hopitals, but

> you can phone and

> ask about surgeons specialized in eyelid surgeries :

> >

> > Hôpital Saint Antoine 184, rue du Faubourg Saint

> Antoine 75012

> PAris (00.33.1.49.28.00)

> >

> > Hôpital des QUINZE-VINGT, 28 rue de Charenton

> 75571 Paris cedex 12

> (00.33.1.40.02.15.20)

> >

> > Hôpital ROTHSCHILD 33, boulevard Picpus 75012

> PARIS

> (00.33.1.40.19.30.00)

> >

> > If you need some help, I can phone and take a

> rendez vous for you.

> >

> > For the surgeries, it's better when you don't

> consider only the

> esthetic problem. Because of the bad quality of

> tears, and because

> the tears become rare (it happened after I began to

> take the pill),

> it's better not to have too big eyes because we

> can't close them in

> the night. As a child, we often have too many tears

> (and people are

> very bad for the mummy because our eyes are not

> clean) and as an

> adult, not enough. I think that what's really

> important is to be able

> to see normally.

> >

> > I hope you will understand my bad english !

> >

> > Good luck in your search of a surgeon.

> >

> >

> >

> > ----Message réexpédié----

> > >A: blepharophimosis

> > >De: " Anja Shahin " <anjashahin@h...>

> > >Date: Wed, 13 Aug 2003 13:13:22 -0000

> > >Sujet: blepharophimosis 14 month old from

> Germany

> > >

> > >Hi,

> > >

> > >I live in Germany, our 14 month old a has

> BPES, she was born

> in

> > >the USA (Seattle). She has been diagnosed when

> she was 2 month

> old.

> > >We have just moved to Berlin-Germany. Apearantly

> there is no need

> for

> > >surgery right now because her vision is not

> affected. She has no

> > >motoric problems, startet crawling at the age of

> 6 month, walking

> at

> > >13 month.

> > >We were advised in Seattle to wait with the

> surgery until the age

> of

> > >4-5y, however we are looking for a plastic

> surgeon in Europe who

> has

> > >experience with the epicantus and ptosis

> procedure. Has anyone of

> you

> > >heard of specialists in Europe? I´d be greatful

> for some advise.

> > >We are getting a genetic testing next week as my

> husband and I do

> not

> > >have BPES but my husbands sister has had ptosis

> (without epicantus

> > >etc..) so the doctors wonder if she might have

> inherited her

> > >condition from her father although he does not

> have it himself ...

> > >Hope to hearing from you soon,

> > >

> > >Anja

> > >

> > >

> > >

> > >

> > >

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I was reading about the surgeon saying you daughter will not be able to

close her eyes after surgery anymore and just wanted to make a comment.

Both my oldest son and myself can close our eyes, but it is when we are

sleep that they won't stay closed. The first time i spent the night with a

friend as a child she seen my eyes were open and started talking to me. She

got freaked out because she thought i was dead. I have never been told that

not not being able to close the eyes could lead to blindness. The only time

blindness was mentioned was if the eyelid covered too much of the pupil.

That was the reason they did a temporary surgery on my youngest son. His

eyes were barily open at all. I could be wrong though about the blindness

possibly with not closing the eyes, but i've never been told that. Has

anybody elses surgeon mentioned that?

While i'm here i guess i'll let everyone know that my son Garrett, 5yrs old,

is going in for his " permanent " first surgery on Friday morning. They are

going to be correcting the epicanthus folds. He is soo excited to be going.

We've been telling him that they are going to start fixing his eyes so they

can be big. He is always asking when he's going to have big eyes. When we

tell him 2 more days he just starts clapping his hands and jumping up and

down. I don't think he really understands that he will post likely be in

some pain afterwards, but we have tried to prepare him the best we can.

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Hi a,

thats interesting, we realised of course thas her lower lids look kind of

loose, but the doctors never mentioned anything about it, however what you

are saying makes sense. Can you eventually find out how the procedure to

tighten the lids is called exactly? We are going to see a new

ophthalmologist in Berlin next week, and I would like to discuss it with

him.

Has anyone else of you heard of this procedure or experience with it?

Thanks, Anja

>From: a Dubreuil <dubie_41@...>

>Reply-blepharophimosis

>blepharophimosis

>Subject: Re: blepharophimosis Re: BPES : 14 month old from Germany

>Date: Wed, 27 Aug 2003 07:00:01 -0700 (PDT)

>

>Anja... My son never cried tears until he was

>three. The surgeon went in and tightened the tendons

>in his bottom lids at the same time of suspending his

>brows. He said that the lack of tightness in his

>bottom lids was the major cause of his light

>sensitivity because his corneas were drying out ( they

>weren't providing the wiping action that a normal lid

>would) Also he couldn't cry tears because the lids

>were so loose that they just pooled in the bottom lids

>and drained back down. As soon as they tightened

>them..he cried tears. It was kind of a strange joy

>for us! I'm not sure exactly what the procedure is

>called...but he had an incision about an inch long

>from the outer corner of each of his eyes. It looked

>pretty rough for about 2 weeks...but now if you didn't

>know he had it done, you don't even see the scars! I

>don't have any pictures of him post-operative tho.

>Not sure if this info is what you were looking for but

>hope it's useful!

>Take Care

>a

>--- Anja Shahin <anjashahin@...> wrote:

> > Hi ,

> >

> > thanks for sharing your experience and the adresses.

> > You are talking

> > about a the tear problem, actually one of my major

> > concerns ..... as

> > a does not seem to have tears at all (not even

> > when she is

> > crying). However it does not seem to be a problem

> > right now, but I am

> > afraid that it will get worse after surgery. We have

> > been told by a

> > plastic surgeon that she will not be able to close

> > her eyes after

> > surgery any more and that this could cause major

> > problems, even lead

> > to blindness!!!!!!! Im totally confused now of

> > course. Hope to

> > hearing from one of you who has had the surgery done

> > already.

> >

> > Anja

> >

> >

> >

> > > Hello,

> > >

> > > My name is . I'm french. I'm 30 years old. I

> > have BPES.

> > > I want to answer to and Anja.

> > >

> > > Anja, I am a sporadic case of BPES. It means that

> > nobody in my

> > family has BPES, except me. No matter. I am not

> > asking myself all day

> > long if one of my parents had geneticly somethin

> > wrong. They have no

> > responsability in my BPES. What'smore, BPES is not

> > an handicap if the

> > parents find a surgeon. Thanks to surgeries, we can

> > see and live

> > normally. Of course, we have problems to bear the

> > light of the sun

> > and sometimes electric light, we have not many tears

> > and they are of

> > bad quality. We look a bit different. I

> > > don't shame my difference, I'am proud of it.

> > >

> > > And if I can have a baby (I don't know if I can or

> > not because of

> > BPES), my baby will maybe have BPES (50% it has

> > BPES, 50% it has

> > not).If it has BPES, I know how to help it, because

> > I lived the same

> > things it lives.

> > >

> > > Anja, your daughter should get a genetic testing

> > too, because you

> > (and she) would maybe know if she will have problems

> > of premature

> > ovarian failure (POF), that concern sometimes women

> > who have BPES.

> > >

> > > In Paris, several hopital make surgeries. I had

> > three surgeries in

> > Hôpital Saint Antoine, but my surgeon doesn't work

> > anylonger (Pr

> > SARAUX).

> > >

> > > In Hôpital NECKER-ENFANTS MALADES, you can contact

> > Pr Jean-Louis

> > DUFIER (00.33.1.44.49.45.02). The address is 149

> > -161 rue de Sèvres

> > 75015 PARIS, Métro DUROC.

> > >

> > > I have no name of surgeon in these hopitals, but

> > you can phone and

> > ask about surgeons specialized in eyelid surgeries :

> > >

> > > Hôpital Saint Antoine 184, rue du Faubourg Saint

> > Antoine 75012

> > PAris (00.33.1.49.28.00)

> > >

> > > Hôpital des QUINZE-VINGT, 28 rue de Charenton

> > 75571 Paris cedex 12

> > (00.33.1.40.02.15.20)

> > >

> > > Hôpital ROTHSCHILD 33, boulevard Picpus 75012

> > PARIS

> > (00.33.1.40.19.30.00)

> > >

> > > If you need some help, I can phone and take a

> > rendez vous for you.

> > >

> > > For the surgeries, it's better when you don't

> > consider only the

> > esthetic problem. Because of the bad quality of

> > tears, and because

> > the tears become rare (it happened after I began to

> > take the pill),

> > it's better not to have too big eyes because we

> > can't close them in

> > the night. As a child, we often have too many tears

> > (and people are

> > very bad for the mummy because our eyes are not

> > clean) and as an

> > adult, not enough. I think that what's really

> > important is to be able

> > to see normally.

> > >

> > > I hope you will understand my bad english !

> > >

> > > Good luck in your search of a surgeon.

> > >

> > >

> > >

> > > ----Message réexpédié----

> > > >A: blepharophimosis

> > > >De: " Anja Shahin " <anjashahin@h...>

> > > >Date: Wed, 13 Aug 2003 13:13:22 -0000

> > > >Sujet: blepharophimosis 14 month old from

> > Germany

> > > >

> > > >Hi,

> > > >

> > > >I live in Germany, our 14 month old a has

> > BPES, she was born

> > in

> > > >the USA (Seattle). She has been diagnosed when

> > she was 2 month

> > old.

> > > >We have just moved to Berlin-Germany. Apearantly

> > there is no need

> > for

> > > >surgery right now because her vision is not

> > affected. She has no

> > > >motoric problems, startet crawling at the age of

> > 6 month, walking

> > at

> > > >13 month.

> > > >We were advised in Seattle to wait with the

> > surgery until the age

> > of

> > > >4-5y, however we are looking for a plastic

> > surgeon in Europe who

> > has

> > > >experience with the epicantus and ptosis

> > procedure. Has anyone of

> > you

> > > >heard of specialists in Europe? I´d be greatful

> > for some advise.

> > > >We are getting a genetic testing next week as my

> > husband and I do

> > not

> > > >have BPES but my husbands sister has had ptosis

> > (without epicantus

> > > >etc..) so the doctors wonder if she might have

> > inherited her

> > > >condition from her father although he does not

> > have it himself ...

> > > >Hope to hearing from you soon,

> > > >

> > > >Anja

> > > >

> > > >

> > > >

> > > >

> > > >

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Hi shelley...You mention your oldest son and yourself, so you have 2 sons with bleph, and yourself also?...how many surgeries have you had? and what about your eldest son?...is this garrets very 1st surgery?...we have been told to wait until our ethan is about 5 years old, thats when they take the tendon form his leg to do the eyelift, do you have pics of yourself etc...post and pre op? we would love to see them:)...we have pics of our wee guy is you wanted to see him...he is only 7 months old...a happy wee man too:)...does any of your ears look slightly different? I know that sounds funny to ask, ethans right ear is cupped over at the top, and his ear- drum hole is a slot shape instead of round? I guess its all linked to the bleph...when ethan cries he doesn't have tears streaming down his face, but his wee eyes go so red:(...with a few tears though, our dr never mentioned anything about the tears???...only started to question it from reading others e-mails on here!...anyways, looking forward to hearing form you soon...bye...leanne:)

Love , Leanne, Tyler & ethan

Re: blepharophimosis Re: BPES : 14 month old from Germany

I was reading about the surgeon saying you daughter will not be able toclose her eyes after surgery anymore and just wanted to make a comment.Both my oldest son and myself can close our eyes, but it is when we aresleep that they won't stay closed. The first time i spent the night with afriend as a child she seen my eyes were open and started talking to me. Shegot freaked out because she thought i was dead. I have never been told thatnot not being able to close the eyes could lead to blindness. The only timeblindness was mentioned was if the eyelid covered too much of the pupil.That was the reason they did a temporary surgery on my youngest son. Hiseyes were barily open at all. I could be wrong though about the blindnesspossibly with not closing the eyes, but i've never been told that. Hasanybody elses surgeon mentioned that?While i'm here i guess i'll let everyone know that my son Garrett, 5yrs old,is going in for his "permanent" first surgery on Friday morning. They aregoing to be correcting the epicanthus folds. He is soo excited to be going.We've been telling him that they are going to start fixing his eyes so theycan be big. He is always asking when he's going to have big eyes. When wetell him 2 more days he just starts clapping his hands and jumping up anddown. I don't think he really understands that he will post likely be insome pain afterwards, but we have tried to prepare him the best we can.

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Yes, i have 2 sons with bleph and myself. I only had 2 surgeries. My grandfather and my father also had bleph. My father never had any surgery for his, but he passed away when i was 5. My grandfather is almost 80 and he finally gave in and decided to have only 1 eye fixed. That was about 7 months ago. He has no interest in getting the other eye fixed at all. My oldest son Austin only had to have 2 surgeries for bleph, but he also had to have tubes in his tear ducts because they were blocked. Austin had just turned 5 yrs old when he had his first surgery and he was 6 almost 7 when he had the 2nd. His surgeon said that there had to a certain amount of distance between the knee and the hip before they could have the muscle from his leg. When i had mine i had donor muscle brought in. This is going to be Garrett's first "permanent" surgery. He had a "temporary" surgery don't when he was 4 months old to raise the eyelids just enough over the pupil so that he wouldn't go blind. I was told that it could come undone. About 2 years ago he had surgery for Duanes Retraction Syndrome and after that surgery i did notice that one of his eyelids was alot lower than it had been. The docs didn't seem to concerened about it though. After this surgery for Garrett on Friday the surgeon said that we had to wait 4-6 months before we could do the next one. Their surgeon told me when Austin had his 2nd surgery that usually bleph gets better as it's passed down, but in our case it has gotten worse. The surgeon said that when he cut open the eyelids there was alot of scar tissue in there, and he hadn't had surgery on his eyelids before. I thought that was kind of interesting. Garrett's eyes are alot worse than mine or Austins. Garrett does have cup shaped ears, but i don't. Austin's are small, but i don't really think they are cup shaped. I have plenty of pictures of all 3 of us if i could ever get a darn scanner. Mine broke right before i joined this group i guess. I went to scan some pictures and it didn't work. Guess it just gave one day without me knowing it. I'm hoping to get one soon though. If you want to know anything else feel free to ask.

I'll let everyone know how things turn out of Friday.

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What is Duanes Retraction Syndrome???

Leanne

Re: blepharophimosis Re: BPES : 14 month old from Germany

Yes, i have 2 sons with bleph and myself. I only had 2 surgeries. My grandfather and my father also had bleph. My father never had any surgery for his, but he passed away when i was 5. My grandfather is almost 80 and he finally gave in and decided to have only 1 eye fixed. That was about 7 months ago. He has no interest in getting the other eye fixed at all. My oldest son Austin only had to have 2 surgeries for bleph, but he also had to have tubes in his tear ducts because they were blocked. Austin had just turned 5 yrs old when he had his first surgery and he was 6 almost 7 when he had the 2nd. His surgeon said that there had to a certain amount of distance between the knee and the hip before they could have the muscle from his leg. When i had mine i had donor muscle brought in. This is going to be Garrett's first "permanent" surgery. He had a "temporary" surgery don't when he was 4 months old to raise the eyelids just enough over the pupil so that he wouldn't go blind. I was told that it could come undone. About 2 years ago he had surgery for Duanes Retraction Syndrome and after that surgery i did notice that one of his eyelids was alot lower than it had been. The docs didn't seem to concerened about it though. After this surgery for Garrett on Friday the surgeon said that we had to wait 4-6 months before we could do the next one. Their surgeon told me when Austin had his 2nd surgery that usually bleph gets better as it's passed down, but in our case it has gotten worse. The surgeon said that when he cut open the eyelids there was alot of scar tissue in there, and he hadn't had surgery on his eyelids before. I thought that was kind of interesting. Garrett's eyes are alot worse than mine or Austins. Garrett does have cup shaped ears, but i don't. Austin's are small, but i don't really think they are cup shaped. I have plenty of pictures of all 3 of us if i could ever get a darn scanner. Mine broke right before i joined this group i guess. I went to scan some pictures and it didn't work. Guess it just gave one day without me knowing it. I'm hoping to get one soon though. If you want to know anything else feel free to ask.

I'll let everyone know how things turn out of Friday.

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Nothing was ever mentioned to me that Duanes Retraction Syndrome was associated with bpes, but what it is...either the muscle that controls the eye is too loose or too tight. To us it would look like Garrett was looking to the left or right, but he would actually be looking straight ahead. His muscles were too tight, and I can't really remember what exactly they did. I do remember the doc. saying that they would snip the muscle but that's about all i remember. Sorry.

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Hi , Leanne, Tyler & Ethan,

just want tro let you know that as left ear is cupped over at the top,

too .... yes, as far as I know this is related to the bleph. We have been

told that it would have been easy to fix the " loop ear " during the first 4

weeks after birth just by taping it back for a while. To correct it later is

quite a bit complicated and cannot be done before 16 or so ....

Cheers, Anja

>From: " tltne " <tltne@...>

>Reply-blepharophimosis

><blepharophimosis >

>Subject: Re: blepharophimosis Re: BPES : 14 month old from Germany

>Date: Fri, 29 Aug 2003 00:08:43 +1200

>

>Hi shelley...You mention your oldest son and yourself, so you have 2 sons

>with bleph, and yourself also?...how many surgeries have you had? and what

>about your eldest son?...is this garrets very 1st surgery?...we have been

>told to wait until our ethan is about 5 years old, thats when they take the

>tendon form his leg to do the eyelift, do you have pics of yourself

>etc...post and pre op? we would love to see them:)...we have pics of our

>wee guy is you wanted to see him...he is only 7 months old...a happy wee

>man too:)...does any of your ears look slightly different? I know that

>sounds funny to ask, ethans right ear is cupped over at the top, and his

>ear- drum hole is a slot shape instead of round? I guess its all linked to

>the bleph...when ethan cries he doesn't have tears streaming down his face,

>but his wee eyes go so red:(...with a few tears though, our dr never

>mentioned anything about the tears???...only started to question it from

>reading others e-mails on here!...anyways, looking forward to hearing form

>you soon...bye...leanne:)

>Love , Leanne, Tyler & ethan

> Re: blepharophimosis Re: BPES : 14 month old from Germany

>

>

> I was reading about the surgeon saying you daughter will not be able to

> close her eyes after surgery anymore and just wanted to make a comment.

> Both my oldest son and myself can close our eyes, but it is when we are

> sleep that they won't stay closed. The first time i spent the night

>with a

> friend as a child she seen my eyes were open and started talking to me.

>She

> got freaked out because she thought i was dead. I have never been told

>that

> not not being able to close the eyes could lead to blindness. The only

>time

> blindness was mentioned was if the eyelid covered too much of the pupil.

> That was the reason they did a temporary surgery on my youngest son.

>His

> eyes were barily open at all. I could be wrong though about the

>blindness

> possibly with not closing the eyes, but i've never been told that. Has

> anybody elses surgeon mentioned that?

> While i'm here i guess i'll let everyone know that my son Garrett, 5yrs

>old,

> is going in for his " permanent " first surgery on Friday morning. They

>are

> going to be correcting the epicanthus folds. He is soo excited to be

>going.

> We've been telling him that they are going to start fixing his eyes so

>they

> can be big. He is always asking when he's going to have big eyes. When

>we

> tell him 2 more days he just starts clapping his hands and jumping up

>and

> down. I don't think he really understands that he will post likely be

>in

> some pain afterwards, but we have tried to prepare him the best we can.

>

>

>

>

>

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